HDFC ERGO Health Insurance: Compare Plans, Benefits, Reviews

HDFC Ergo General Insurance Company is a leading name in the general insurance industry. The company has been established as a joint venture between HDFC Limited and ERGO International AG. While HDFC Limited is a leading financial services company of India, ERGO International AG is the main insurance company of the Munich Re Group. HDFC Ergo offers a range of general insurance products which meet the insurance requirements of common individuals as well as corporate entities. You can find motor insurance plans, travel insurance plans, fire insurance plans, commercial insurance plans and health insurance plans offered by HDFC Ergo. All the company’s plans provide a good scope of cover and come with competitive premiums.

HDFC Ergo health insurance review – Facts about the company

Here is the range of HDFC Ergo medical insurance plans offered and their details in brief –

1. The company is spread across more than 100 cities of India with 120+ branches and 3000+ employees working for it
2. ICRA has conferred the company with a rating of ‘iAAA’ because of the high claim settlement record that the company has
3. The company also enjoys ISO certification for its efficient services in customer service, policy issuance, technological developments, etc.
4. The company has won various awards over the years since it was established.
5. More than 1 crore customers are currently being served by HDFC Ergo

Benefits of HDFC Ergo medical insurance plans

HDFC Ergo offers some of the best health insurance plans. Moreover, its plans also provide you the following benefits –

1. The company offers you round the clock assistance for your grievances and product related queries
2. 90% of the pre-authorised cashless claims which are made under HDFC Ergo health insurance plans are approved by the company within 20 minutes. This ensures that your claim settlement is easy and quick
3. HDFC Ergo health insurance plans offer the facility of a Wellness Application which can be downloaded on your Smartphone. This application helps you lead a healthy lifestyle and also rewards you for doing so
4. HDFC Ergo medical insurance policies are issued online without the need of lengthy paperwork. This makes buying the policies an easy affair
5. The company has a network of more than 10,000 hospitals across India to cater to cashless claim settlements

Click the link below, enter a few details & sail away with the most appropriate health insurance policy for your needs.

Browse HDFC ERGO Health Insurance Policy Online

HDFC Ergo health insurance review – Key features of HDFC Ergo health insurance plans

HDFC Ergo medical insurance plans have the following salient features-

• A range of health insurance policies is issued by the company. You can buy a policy to cover yourself, your family members and also dependent senior citizen parents
• Critical illness policy is also offered by the company which covers a list of critical illnesses and pays a lump sum benefit on their diagnosis
• Personal accident plans are also available which cover accidental injuries and pay a lump sum benefit at the time of claims
• All health plans offered by the company allow lifelong renewals
• There are optional coverage benefits too which can be added to your policy for a more inclusive scope of cover

HDFC Ergo health insurance review – Types of plans

Here is the range of health insurance plans offered by the company and their details in brief –

1. HDFC ERGO my:health Suraksha Insurance Silver Smart Plan

This is an indemnity health insurance plan which allows affordable coverage levels and covers the medical costs that you actually incur. The salient features of the plan are as follows

• The plan can be bought by individuals, by families and also by senior citizens
• There is no sub-limit on the room rent
• The sum insured is reinstated if your base sum insured is used up in a policy year
• In-home treatments can also be taken on a cashless basis
• Mental illnesses are also covered under the plan
• Optional covers are also available with the plan for a more inclusive scope of coverage

Eligibility conditions of HDFC ERGO my:health Suraksha Insurance – Silver Smart Plan

Entry age	18 years onwards Dependent children can be covered from 91 days to 25 years
Term of the plan	1 to 3 years
Sum insured	INR 3 lakhs to INR 5 lakhs
Pre-entrance health check-up	Not required till 45 years of age and up to INR 20 lakhs sum insured
No claim bonus	10% increase in sum insured for each claim-free year up to a maximum of 100%
Pre-existing waiting period	3 years

2. HDFC ERGO my:health Suraksha Insurance Gold Smart Plan

This is a more comprehensive version of the Silver Smart Plan. The plan also covers actual medical expenses and comes with a range of add-on covers. The salient features of the plan are as follows –

• Air ambulance cover is available under the plan for up to INR 2 lakhs
• You get a lump sum recovery benefit if you are hospitalised for 10 or more days
• Free annual health check-ups are allowed under the plan
• Maternity cover can be taken as an optional cover by paying an additional premium
• Critical illness and hospital cash benefit add-ons can be taken under the policy

Eligibility conditions of HDFC ERGO my:health Suraksha Insurance – Gold Smart Plan

Entry age	18 years onwards Dependent children can be covered from 91 days to 25 years
Term of the plan	1 to 3 years
Sum insured	INR 7.5 lakhs, INR 10 lakhs and INR 15 lakhs
Pre-entrance health check-up	Not required till 45 years of age and up to INR 20 lakhs sum insured
No claim bonus	10% increase in sum insured for each claim-free year up to a maximum of 100%
Pre-existing waiting period	3 years

3. HDFC ERGO my:health Suraksha Insurance – Platinum Smart Plan

This is the most premium cover under the HDFC ERGO my:health Suraksha health insurance plans. The plan provides coverage for almost all types of medical expenses as well as options for policy extensions and riders. The salient features of the policy are as follows –

• There is no limit on the entry age. Individuals of all ages can buy the plan
• Coverage up to INR 75 lakhs can be taken under this variant
• Both road and air ambulance cover is available under the plan
• The sum insured is refilled if it is exhausted on previous claims in the same policy year
• Coverage for infertility treatments can be taken as an optional benefit
• There are premium discounts for adding two or more family members and also for buying more than one policy from HDFC Ergo

Eligibility conditions of HDFC ERGO my:health Suraksha Insurance – Platinum Smart Plan

Entry age	18 years onwards Dependent children can be covered from 91 days to 25 years
Term of the plan	1 to 3 years
Sum insured	INR 7.5 lakhs, INR 10 lakhs and INR 15 lakhs
Pre-entrance health check-up	Not required till 45 years of age and up to INR 20 lakhs sum insured
No claim bonus	25% increase in sum insured for each claim-free year up to a maximum of 200%
Pre-existing waiting period	3 years

4. HDFC ERGO Health Suraksha Silver Plan

This is a simple health insurance plan which offers affordable coverage and has the following salient features –

• Inpatient hospitalisation has no sub-limits on room rent or other expenses
• A no claim bonus of 5% is allowed for each claim-free year
• You can buy the policy at any age as there is no limit on entry age
• The policy can be taken on an individual or floater sum insured basis
• 10% premium discount is allowed if two or more family members are covered under the plan on individual sum insured basis
• Coverage is also available for non-allopathic AYUSH treatments
• Free health check-ups are allowed once after every four claim-free years

Eligibility conditions of HDFC ERGO Health Suraksha Silver plan

Entry age	18 years onwards Children aged 5 years and above can be covered if both parents are covered
Term of the plan	1 or 2 years
Sum insured	INR 3 lakhs to INR 7.5 lakhs
Pre-entrance health check-up	Not required until 45 years of age
No claim bonus	5% increase in sum insured for each claim-free year up to a maximum of 50%
Pre-existing waiting period	4 years

5. HDFC ERGO Health Suraksha Gold Plan

This is another variant of the HDFC ERGO Health Suraksha policy albeit with a wider scope of coverage. The features of the plan are as follows –

• A family discount of 10% is allowed in the premium rate if two or more members are covered under the policy
• Coverage is available up to INR 10 lakhs
• There is no limit on the entry age
• Maternity expenses and newborn baby cover is inbuilt in the plan’s coverage features
• You can also get an e-opinion from the company’s team of medical experts if you suffer from a critical illness. This service would be free of cost
• This HDFC Ergo medical insurance plan has an optional regain benefit which refills the sum insured in case it is used up in a claim in the policy year
• You can also choose to enhance the no claim bonus to 10% by paying an additional premium

Eligibility conditions of HDFC ERGO Health Suraksha Gold plan

Entry age	18 years onwards Children aged 5 years and above can be covered if both parents are covered
Term of the plan	1 or 2 years
Sum insured	INR 3 lakhs to INR 10 lakhs
Pre-entrance health check-up	Not required until 45 years of age
No claim bonus	5% increase in sum insured for each claim-free year up to a maximum of 50%
Pre-existing waiting period	4 years

6. HDFC ERGO my:jeevika Cash@Hospital Micro Insurance Plan

This is a micro-insurance health plan which offers coverage for the rural population of India. This is a fixed benefit health insurance plan under which a fixed amount of daily benefit is paid if the insured is hospitalised for a period of 24 hours or more. The features of the plan are as follows –

• There are three plan variants of Silver, Gold and Platinum
• The hospital cash benefit can go up to INR 1000 per day of hospitalisation
• The claim paid does not depend on the actual medical costs that you incur. In case of hospitalisation, the fixed benefit is paid as a claim
• You can use the claim to meet any medical expenses which might not be covered under your standard health insurance plan

Eligibility conditions of HDFC ERGO my:jeevika Cash@hospital Micro Insurance Plan

Entry age	18 years onwards Dependent children can be covered from 6 months to 18 years if one or both parents are covered
Term of the plan	1 year
Hospital cash benefit	Silver plan – INR 250/day of hospitalisation Gold Plan – INR 500/day of hospitalisation Platinum plan – INR 1000/day of hospitalisation
Sum insured	Silver Plan – INR 7500 Gold plan – INR 15,000 Platinum Plan – INR 30,000
Premium rate	Silver plan – INR 180 Gold Plan – INR 330 Platinum Plan – INR 660
Pre-entrance medical check-ups	Not required
Pre-existing waiting period	4 years

7. HDFC ERGO my:jeevika Medisure Micro Insurance

This is also a micro-insurance plan which provides indemnity oriented health insurance coverage with the rural population of India. The plan covers the actual hospital bills up to the specified sum insured. The features of the plan are as follows –

• Inpatient hospitalisation is covered under the plan
• AYUSH treatments taken at a recognised hospital would also be covered
• You can take the policy to cover only yourself or your entire family members

Eligibility conditions of HDFC ERGO my:jeevika Medisure Micro Insurance Plan

Entry age	18 years to 65 years Children aged 6 months to 18 years can be covered under floater plans
Term of the plan	1 year
Sum insured	INR 30,000
Pre-entrance health check-up	Not required
Pre-existing waiting period	4 years

8. HDFC ERGO my:health Medisure Super Top-up Insurance plan

This is a super top-up health insurance policy which has a specific deductible limit. If the total claims in a policy year exceed the deductible limit, the plan pays the excess claim. This plan can be taken to increase your sum insured. The features of the plan are as follows –

• There are different combinations of the sum insured and deductible options to choose from
• The premiums remain fixed after you attain 61 years of age
• No capping is done on inpatient hospitalisation coverage
• You can buy the policy either on an individual basis or on a family floater sum insured basis
• Premiums are not increased on renewals even if a claim is made
• 5% premium discount is allowed if you buy a two-year policy

Eligibility conditions of HDFC ERGO my:health Medisure Super Top-up Insurance Plan

Entry age	18 years to 65 years Dependent children – 91 days to 23 years
Term of the plan	1 or 2 years
Sum insured	INR 3 lakhs to INR 20 lakhs
Deductible limit	INR 2 lakhs to INR 5 lakhs
Pre-entrance health check-up	Not required until 55 years of age
Pre-existing waiting period	3 years

9. HDFC ERGO Critical Illness Silver Plan

This is a fixed benefit health insurance plan which covers a list of critical illnesses. If you are diagnosed with any of the covered illness, the plan pays the sum insured in lump sum irrespective of the medical costs that you incur. The features of the plan are as follows- 

• 8 major illnesses are covered under the plan
• Coverage of up to INR 50 lakhs can be taken against the covered illnesses
• You can choose the survival period after which the critical illness claim would be paid by the company

Eligibility conditions of HDFC ERGO Critical Illness Silver plan

Entry age	5 years to 65 years
Term of the plan	1 year
Sum insured	INR 1 lakh to INR 50 lakhs
Pre-entrance health check-up	Depends on the age and sum insured selected

10. HDFC ERGO Critical Illness Platinum Plan

This is also a critical illness health insurance plan which pays a fixed benefit on diagnosis of the covered illnesses. However, the plan covers more illnesses and has the following features –

• 15 critical illnesses are covered under the plan
• The policy can be renewed lifelong
• The survival period can be chosen to be as low as 15 days

Eligibility conditions of HDFC ERGO Critical Illness Platinum plan

Entry age	5 years to 65 years
Term of the plan	1 year
Sum insured	INR 1 lakh to INR 50 lakhs
Pre-entrance health check-up	Depends on the age and sum insured selected

11. HDFC ERGO Health Suraksha Top-up Plan

This is a supplemental health insurance plan like a super top-up plan. Under this plan also the aggregate claims are considered against the deductible limit and if the total claim in a year exceeds the deductible limit, the claim is paid. The features of the plan are as follows –

• You can buy the plan on a family floater basis also
• If you insure three or more family members on an individual coverage basis, you can avail a premium discount of 10%
• There are no sub-limits on room rents, doctor’s fee and other inpatient hospitalisation expenses
• Domiciliary treatments are also covered under the policy

Eligibility conditions of HDFC ERGO Health Suraksha Top-up Plan 

Entry age	5 years to 65 years Children aged 91 days and above can be covered if both parents are also covered under the policy
Term of the plan	1 or 2 years
Sum insured	INR 3 lakhs to INR 10 lakhs
Deductible limit	INR 2 lakhs to INR 5 lakhs
Pre-entrance health check-up	Not required till 55 years of age
No claim bonus	5% increase in sum insured after every claim-free year
Pre-existing waiting period	4 years

HDFC ERGO, therefore, offers the above-mentioned health insurance policies. You can pick any policy based on your coverage needs from the list of plans offered.

Coverage and exclusions under HDFC Ergo health insurance plans

Now that you know the different policies offered by HDFC Ergo, let’s have a look at the coverage benefits and exclusions which are common to the above-mentioned health insurance plans –

• Coverage benefits
• Inpatient hospitalisation expenses which include the cost of room rent, doctor’s fee, nurse’s fee, treatment costs, etc.
• Pre hospitalisation expenses
• Post hospitalisation expenses
• Daycare treatments
• Cost of road ambulance
• Domiciliary treatments which are taken at your home
• Organ donor treatments where the cost of harvesting the organ is covered
• Free health check-ups at specified intervals during the policy
• Exclusions
• Pre-existing illnesses are not covered from the start of the policy. They are covered after a specified waiting period
• Illnesses incurred within the first 60 to 90 days of buying the policy are not covered
• Pregnancy-related costs and expenses are not covered unless they are specifically included in the plan’s coverage benefits
• Cosmetic treatments, LASIK surgery, dental treatments, etc. are not covered
• Unproven and experimental treatments are not covered
• Self-inflicted injuries and attempted suicides are excluded from coverage
• Injuries or illnesses due to war, radiation, nuclear contamination, etc. are not covered
• Participation in defence-related activities or any other hazardous activities would not be covered
• HIV/AIDS and other sexually transmitted illnesses are not covered

How to buy HDFC Ergo health insurance plans?

You can buy HDFC Ergo health insurance plans online through the company’s website or through Turtlemint. While the company’s website would allow you to buy the plan that you want, on Turtlemint you would be given a choice of similar health insurance plans for comparison. This comparison would allow you to compare the coverage benefits of different plans and then select the plan which has the best features without taxing your pockets.

To buy through Turtlemint, you should take the following steps –

1. Visit https://www.turtlemint.com/health-insurance and choose whether you want to buy a new policy or top-up an existing one
2. Provide your details based on which the coverage and premium would be calculated. The details include your age, gender, members to be covered under the plan, pre-existing illnesses if any, annual income, etc.
3. Once the details are entered, you would be shown a list of some of the best health insurance policies which would also include HDFC Ergo health insurance plans
4. Compare the plans and choose the best one
5. Fill up an online application form and pay the premium online to buy the policy quickly

Things to consider before buying HDFC Ergo health insurance

Before you buy an HDFC Ergo health insurance policy, the following points should be kept in mind –

1. All your family members should be covered under the plan
2. The sum insured should not be too low. You should opt for an optimal coverage level which would help you meet the high medical costs in times of need
3. Look for different types of premium discounts offered by HDFC Ergo health insurance plans. These discounts would lower your premiums
4. The premiums should be affordable so that you can continue the plan lifelong

How to renew HDFC Ergo health insurance plans?

Health insurance plans allow lifelong coverage if you renew them on time. Thus, renewal is necessary to enjoy uninterrupted coverage. To renew the policy, you can visit HDFC Ergo’s official website https://www.hdfcergo.com/ and choose ‘Renew’. Then provide your policy details, pay the renewal premium and the policy would be renewed online.

If you have bought the policy from Turtlemint, you can log into your online Turtlemint account, choose the policy and click on ‘Renew’. Renewal would be done instantly when you pay the renewal premiums online.

How to make a claim in HDFC Ergo health insurance plans?

Claims under HDFC Ergo health insurance plans occur when you or your insured family member faces a medical emergency and is hospitalised. In the case of claims, the following steps should be taken –

1. Inform HDFC Ergo immediately about the claim
2. Locate the networked hospital closest to your area and get admitted there for cashless claims
3. You would have to fill up a pre-authorization form and submit it with HDFC Ergo for cashless claims. This form should be submitted either within 24 hours of an emergency hospitalisation or 3-4 days before a planned hospitalisation
4. Based on the pre-authorization form, the claim would be approved
5. You can take treatments at the hospital and the insurance company would bear the medical costs
6. After you are discharged, fill up the claim form and submit it with other claim related documents to get the claim settled
7. If you have taken treatments at a hospital which is not tied-up with HDFC Ergo, your claim would be settled on a reimbursement basis. You would have to pay the medical costs yourself and get treated. After discharge, submit the claim form and the relevant documents and the insurance company would reimburse the costs that you have incurred.

Alternatively, if you buy your policy through Turtlemint, you do not have to take the above-mentioned steps. You just have to inform Turtlemint at 1800 266 0101 or claims@turtlemint.com and the company would take up your claim. Turtlemint would coordinate with HDFC Ergo, follow the claim procedure and get your claim settled at the earliest.

Documents required for making a claim

To make a claim in your HDFC Ergo health insurance policy, the following documents would have to be submitted –

1. Claim form
2. Identity proof
3. Discharge summary
4. Medical bills and reports
5. All hospital bills and reports
6. Doctor’s prescriptions
7. Other documents as needed by HDFC Ergo

HDFC Ergo health insurance review

HDFC Ergo is a reputed brand name and it offers a range of varied health insurance plans. Given the variety of health insurance plans, HDFC Ergo health insurance policies are quite suitable for individuals with different coverage needs. The premiums are also low and the coverage levels are optimal enough to meet the expensive medical treatments. So, if you are looking for a comprehensive health insurance policy, you can choose from HDFC Ergo’s health insurance plans.